SEARCH · PubMed Health

Results for “Implementation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources

PubMed2005

Control of Taenia solium taeniasis/cysticercosis: from research towards implementation.

Theoretically, considering the biology of its transmission and reservoirs, global eradication of Taenia solium taeniasis and cysticercosis is feasible. Recently much progress has been made in research on diagnosis, treatment and prevention of human taeniasis and porcine cysticercosis, although more operational research is still needed. In spite of this, global eradication of T. solium infection is still unlikely in the near future. Major obstacles to practical implementation of control measures include low levels of sanitation and health education amongst endemic populations, ineffective health services infrastructure and inadequate socioeconomic development in these areas. The continued public health impact of neurocysticercosis, especially fatalities and epilepsy, force us to identify improved options for control. In order to implement control measures in highly endemic areas the active involvement of medical services in controlling T. solium infection and more effective collaboration between medical and veterinary services is necessary. A switch is suggested from total reliance on meat inspection to active diagnosis and treatment of human taeniasis, protection of pigs against infection, promotion of health education and improved surveillance preparing chemotherapeutic and/or sanitary interventions. This could be implemented in areas where active transmission causes substantial morbidity and mortality provided there is the political will, social support, better financing and an effective organizational framework.

Animals↗

PubMed2004

Readiness to implement Hazard Analysis and Critical Control Point (HACCP) systems in Iowa schools.

OBJECTIVE: To evaluate current food-handling practices, food safety prerequisite programs, and employee knowledge and food safety attitudes and provide baseline data for implementing Hazard Analysis and Critical Control Point (HACCP) systems in school foodservice. DESIGN: One member of the research team visited each school to observe food-handling practices and assess prerequisite programs using a structured observation form. A questionnaire was used to determine employees' attitudes, knowledge, and demographic information. SUBJECTS/SETTING: A convenience sample of 40 Iowa schools was recruited with input from the Iowa Department of Education. STATISTICAL ANALYSES: Descriptive statistics were used to summarize data. One-way analysis of variance was used to assess differences in attitudes and food safety knowledge among managers, cooks, and other foodservice employees. Multiple linear regression assessed the relationship between manager and school district demographics and the food safety practice score. RESULTS: Proper food-handling practices were not being followed in many schools and prerequisite food safety programs for HACCP were found to be inadequate for many school foodservice operations. School foodservice employees were found to have a significant amount of food safety knowledge (15.9+/-2.4 out of 20 possible points). School districts with managers (P=.019) and employees (P=.030) who had a food handler certificate were found to have higher food safety practice scores. APPLICATIONS/CONCLUSIONS: Emphasis on implementing prerequisite programs in preparation for HACCP is needed in school foodservice. Training programs, both basic food safety such as ServSafe and HACCP, will support improvement of food-handling practices and implementation of prerequisite programs and HACCP.

Adolescent↗

PubMed2004

Food safety practices and readiness to implement HACCP programs in assisted-living facilities in Iowa.

OBJECTIVE: To evaluate current food-handling practices and employee food safety knowledge and attitudes and to provide baseline data for implementing the Hazard Analysis and Critical Control Point (HACCP) program in assisted-living foodservices for elderly persons. DESIGN: Food-handling practices were observed at each assisted-living facility using a structured observation form. A validated questionnaire was used to determine demographic information and employees' attitudes and knowledge about food safety. SUBJECTS/SETTING: A convenience sample of 40 assisted-living facilities in Iowa was recruited from a list obtained from the Iowa Department of Elder Affairs. STATISTICAL ANALYSES PERFORMED: Descriptive statistics were used to summarize data. One-way analysis of variance was used to assess differences in attitudes and food safety knowledge among the managers, cooks, and other foodservice employees. Multiple linear regression determined the relationship between manager and facility demographics and the food safety practice score. RESULTS: Proper food-handling practices were followed in many assisted-living facilities, but areas in need of improvement were identified. Some HACCP prerequisite programs were found to be inadequate, including a lack of written standard operating procedures, documentation of food safety practices, and training. Temperatures and chemical concentrations need to be checked routinely. Foodservice employees had a significant amount of food safety knowledge (14.6+/-3.0 out of 20 possible points), and employees with food safety certification scored higher than those with no certification (15.6+/-2.6 and 13.9+/-3.1, respectively; P </=.001). CONCLUSIONS: Training programs, both basic food safety and the HACCP program, will support improvement of safe food-handling practices and implementation of prerequisite programs and the HACCP program. Developing prerequisite programs, including sanitation standard operating procedures, will aid assisted-living facilities in moving toward HACCP program implementation.

Adult↗

PubMed2004

Process implementation aspects for biocatalytic hydrocarbon oxyfunctionalization.

Oxidoreductases catalyze a large variety of regio-, stereo-, and chemoselective hydrocarbon oxyfunctionalizations, reactions, which are important in industrial organic synthesis but difficult to achieve by chemical means. This review summarizes process implementation aspects for the in vivo application of the especially versatile enzyme class of oxygenases, capable of specifically introducing oxygen from molecular oxygen into a large range of organic molecules. Critical issues such as reaching high enzyme activity and specificity, product degradation, cofactor recycling, reactant toxicity, and substrate and oxygen mass transfer can be overcome by biochemical process engineering and biocatalyst engineering. Both strategies provide a growing toolset to facilitate process implementation, optimization, and scale-up. Major advances were achieved via heterologous overexpression of oxygenase genes, directed evolution, metabolic engineering, and in situ product removal. Process examples from industry and academia show that the combined use of different concepts enables efficient oxygenase-based whole-cell catalysis of various commercially interesting reactions such as the biosynthesis of chiral compounds, the specific oxyfunctionalization of complex molecules, and also the synthesis of medium-priced chemicals. Better understanding of the cell metabolism and future developments in both biocatalyst and bioprocess engineering are expected to promote the implementation of many and various industrial biooxidation processes.

Biotechnology↗

PubMed2005

Implementation of the Canadian C-spine rule reduces cervical spine x-ray rate for alert patients with potential neck injury.

The objectives of this before-and-after study of alert, stable adult patients presenting to the Emergency Department of Western Hospital with potential neck injuries who were immobilized in hard cervical collars were to determine the impact of implementation of the Canadian C-spine rule on x-ray ordering rates and whether implementation of the rule reduced time in hard collars for patients with potential neck injury. Data collected included demographics, mechanism of injury, x-ray rate, and time in hard collar. Data analysis was by chi-square test for proportions and Mann-Whitney U test for continuous variables. There were 211 patients studied. The x-ray ordering rate decreased from 67% to 50% (25% relative reduction, p = 0.0187). Time in hard collar was also reduced from a median of 128 min to a median of 103 min (effect size 25.5 min), but this did not reach statistical significance. Implementation of the Canadian C-spine rule reduced x-ray ordering by 25%.

Adolescent↗

PubMed2006

Aggregating high-priority landscape areas to the parcel level: an easement implementation tool.

Landscape characteristics and parcel ownership information are often collected on different spatial scales leading to difficulties in implementing land use plans at the parcel level. This study provides a method for aggregating highly resolute landscape planning information to the parcel level. Our parcel prioritization model directly incorporates a Land Trust's conservation goals in the form of a compromise programming model. We then demonstrate the use of our approach for implementation decisions, including parcel selection under a budget constraint and the estimation of a total conservation budget necessary to meet specific conservation goals. We found that these cost constraints significantly alter the composition of the 'best' parcels for conservation and can also provide guidance for implementation. The model's results were integral to a local Land Trust's ability to further define and achieve their goals.

Biodiversity↗

PubMed2003

Practical applications approach to design, development and implementation of an integrated management system.

The introduction of quality, risk, safety, health and environmental management philosophies has significantly changed industry's view of company organization and controlling processes. Quality, risk, safety, health and environmental programs and systems, such as ISO 9000, ISO 14000, process safety, and risk management are impacting the way industry will meet the challenges of safety and environmental risks and the needs of the customer in the future.A wealth of knowledge has been extracted from practical application case studies, which would otherwise be unobtainable without years of experience related to management systems design, development, implementation and control. This paper discusses a practical applications approach to design, develop and implement an integrated management system encompassing quality (ISO 9000), process safety management (CFR 29 1910.119), risk management programs (CFR 40 part 68), environmental management (ISO 14000), and safety and health. This paper includes a discussion of management systems integration and an overview of management systems standards that apply to the petrochemical and chemical manufacturers industries. The paper also provides an overview on integrating management systems, including issues related to the following topics: Establishing a management system team and objectives. Assessing and knowing your organization. Designing the management system to meet site objectives. Developing system documentation. Implementing effective management systems. Measuring program performance. Continuous improvement.

Carcinogens↗

PubMed2006

Implementation and performance evaluation of reconstruction algorithms on graphics processors.

The high-throughput needs in electron tomography and in single particle analysis have driven the parallel implementation of several reconstruction algorithms and software packages on computing clusters. Here, we report on the implementation of popular reconstruction algorithms as weighted backprojection, simultaneous iterative reconstruction technique (SIRT) and simultaneous algebraic reconstruction technique (SART) on common graphics processors (GPUs). The speed gain achieved on the GPUs is in the order of sixty (60x) to eighty (80x) times, compared to the performance of a single central processing unit (CPU), which is comparable to the acceleration achieved on a medium-range computing cluster. This acceleration of the reconstruction is caused by the highly specialized architecture of the GPU. Further, we show that the quality of the reconstruction on the GPU is comparable to the CPU. We present detailed flow-chart diagrams of the implementation. The reconstruction software does not require special hardware apart from the commercially available graphics cards and could be easily integrated in software packages like SPIDER, XMIPP, TOM-Package and others.

Algorithms↗

PubMed2006

Nurse teachers' knowledge in curriculum planning and implementation.

BACKGROUND: Nurses are required to base care on research evidence but research findings on nursing practice often suggest that the linkage is poor and ritualistic routines often prevail. AIMS: The study explored the origin and nature of knowledge utilised by nurse teachers when developing and implementing a curriculum. METHODS: In a single, ethnographic case study data were collected from two curriculum development and two curriculum implementation groups, using interviews, participant observation and documents. The study drew directly on Bernstein's theory of the pedagogic device and cultural reproduction. RESULTS: Findings suggested that even though nurse education appears to be dominated by policies and guidelines produced by state agencies, it was teachers operating at institutional and classroom levels who determined what was delivered to student nurses as they relied upon their experience of teaching and clinical practice to plan and implement curriculum. Notwithstanding both national and local aspirations to the contrary, teaching and assessment practices were mostly teacher- rather than student-centred, with heavy reliance on propositional knowledge. CONCLUSION: The practices identified within this study may induce approaches to learning that may be antithetical to delivering research based care within a prevailing climate that advocates evidence-based practice, clinical effectiveness and governance.

Anthropology, Cultural↗

PubMed2006

Fast algorithm and implementation of dissimilarity self-organizing maps.

In many real-world applications, data cannot be accurately represented by vectors. In those situations, one possible solution is to rely on dissimilarity measures that enable a sensible comparison between observations. Kohonen's self-organizing map (SOM) has been adapted to data described only through their dissimilarity matrix. This algorithm provides both nonlinear projection and clustering of nonvector data. Unfortunately, the algorithm suffers from a high cost that makes it quite difficult to use with voluminous data sets. In this paper, we propose a new algorithm that provides an important reduction in the theoretical cost of the dissimilarity SOM without changing its outcome (the results are exactly the same as those obtained with the original algorithm). Moreover, we introduce implementation methods that result in very short running times. Improvements deduced from the theoretical cost model are validated on simulated and real-world data (a word list clustering problem). We also demonstrate that the proposed implementation methods reduce the running time of the fast algorithm by a factor up to three over a standard implementation.

Algorithms↗

PubMed2004

Implementing asthma education programmes in paediatric respiratory care: settings, timing, people and evaluation.

Randomised controlled trials have shown that asthma education programmes in paediatric care can improve the ability of children and their parents to control their asthma. This paper discusses the implementation of asthma education within pragmatic care. Key times for implementation are suggested: at the initial diagnosis, after acute asthma events such as hospitalisation, at the time of medication change and at regular review. Special issues, such as implementing programmes for teenagers, are discussed. Evaluation is recommended for processes (does the practice have an agreed protocol for education, does it have a key person with responsibility for co-ordinating education within the clinic or practice, does it have agreed outcomes for audit of education?). Evaluation is also recommended for individual outcomes (clinical improvement and increase in perceived asthma control and confidence in management).

Adolescent↗

PubMed2004

Implementation of cardiopulmonary resuscitation guidelines in elderly care departments across: a survey of 13 hospitals shows wide variability in practice.

OBJECTIVE: The United Kingdom Department of Health advises hospitals that they should implement a policy relating to cardiopulmonary resuscitation (CPR) that takes account of published guidelines relating to decision making for resuscitation. We wished to see if these guidelines were leading to implementation of a similar policy in different Elderly Care (EC) departments. SETTING: The acute and rehabilitation wards in 13 hospitals from the South Thames West region. DESIGN: On one day the notes of all in-patients, over 55 years, under the care of an EC physician were reviewed. RESULTS: A CPR decision had been made in 465 (47%) of the 990 in-patients, 379 Do Not Attempt Resuscitation (DNAR) orders were made. The percentage of patients in whom a CPR decision had been made varied from 15 to 97% between departments. CONCLUSIONS: Implementation of the guidelines for decision making for resuscitation varies greatly across this region of the United Kingdom.

Aged↗

PubMed2005

Evaluation of a new approach to implement structured, evidence-based emergency medical care in undergraduate medical education in Germany.

Since June 2002, revised regulations in Germany allow medical faculties to implement new curricular concepts. The medical faculty of the Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen, Germany, decided to start a major reform experiment in winter 2003, focussing on an interdisciplinary integration of organs and organ systems such as the cardiovascular or respiratory system. Furthermore, students will have contact with patients at an early stage of their studies. Thus, re-organisation of course contents should lead to a chance to improve practical experience. With the public having the right to expect that physicians and all physicians in training possess a basic knowledge of emergency medical care and the necessary skills to manage acute problems, it was decided to start the first year of the Medical Reform Curriculum Aachen with 3 weeks interdisciplinary introduction into emergency medical care. The task consisted of defining interdisciplinary core objectives and the need to implement teaching and learning principles necessary for further education. Due to this, the content of this course should have practical relevance for the students concerning their practical experiences in the future. The result is an introductory course in emergency medical care in the first semester, coordinated with the lectures. Besides skill training on basics of emergency medical care (basic life support (BLS), early defibrillation), practical training in other lifesaving techniques (e.g., immobilisation skills) and basic principles of daily clinical care are included. In addition, personal safety and a standard algorithm for assessing the patient are covered by problem-based learning sessions. The course evaluation data clearly showed acceptance of the new approach and enhances possibilities of extending implementation of relevant topics concerning emergency medical care within the Medical Reform Curriculum Aachen.

Curriculum↗

PubMed2005

Asthma outpatient education by multiple implementation strategy. Outcome of a programme using a personal notebook.

More than 10 years after publication, international guidelines remain poorly implemented. To better implement them, we need to develop new strategies adapted to the expectations of patients and health professionals outside hospital settings and to ensure better outpatient follow up in the community. We developed a bilingual education programme including a brochure designed to support an interdisciplinary health care network and measured hospitalisations (H), work absenteeism (WA), emergency visits (EV), asthma medication (AM) and quality of life (QL Juniper) before and 12 months after the intervention. All QL scores improved significantly in comparison with pre-intervention values. Health service use decreased dramatically when comparing the 12 months prior to and after the intervention(H: 35-8%, WA: 39-14%, EV: 88-53%). The final cost/benefit ratio of the programme was 1.96. Interdisciplinary implementation strategy of patient education is cost-effective, improves quality of life for asthmatics, and reduces strain on health services. Such a health care network does not require an expensive infrastructure and is better adapted to the reality and competences of clinical practice.

Adolescent↗

PubMedDate not supplied

Challenges and lessons learned since implementation of the safety pharmacology guidance ICH S7A.

The International Conference on Harmonization, Topic S7A guidance (ICH S7A) on safety pharmacology for human pharmaceuticals has been in effect for 3 years in Europe, the United States and Japan. Surveys of the pharmaceutical industry, regulatory agencies and the audience attending the 4th Annual Meeting of the Safety Pharmacology Society have helped identify and address areas of controversy, as well as those challenges that have emerged since implementation of the guidance worldwide. Overall, ICH S7A has been successfully implemented. The guidance provides for "Good Laboratory Practice" compliant "safety pharmacology core battery" of studies that are generally performed prior to first administration to humans. The approach is science-driven and specifies the use of robust and sophisticated in vitro and/or in vivo assays. There are, however, some areas that require further refinement/clarification such as the specifics of study design including the selection of dose/concentration, choice of species, modeling of the temporal pharmacodynamic changes in relation to pharmacokinetic profile of parent drug and major metabolites, use of an appropriate sample size, statistical power analysis as a means of demonstrating the sensitivity of the model system, testing of human-specific metabolites and demonstrating not only the model's sensitivity, but also its specificity for predicting adverse events in humans. There was also discussion of when these studies are needed in relation to the clinical development plan. Representatives from the pharmaceutical industry and regulatory agencies see the implementation of ICH S7A as a major step forward towards identifying the risk to Phase 1 and 2 volunteers and patients. It remains to be seen, however, whether and in what ways the ICH S7A-based strategy will contribute to the modification of the integrated risk assessment during the latter stages of clinical development or once drugs have been introduced to the marketplace.

Animals↗

PubMed2003

School climate and implementation of the Pathways study.

BACKGROUND: Pathways was a multisite school-based study to prevent obesity in American Indian school children by encouraging healthy eating and physical activity. METHODS: Over the 3-year study, a total of 290 in-depth interviews were conducted with school administrators, food service managers, classroom teachers, and physical education instructors in all 21 intervention schools to examine support and barriers for Pathways. Analysis included qualitative assessment of key themes using NUD*IST and quantitative modeling of the impact of a school climate score on implementation of intervention components. RESULTS: Overall, teachers, food service managers, and physical education instructors were supportive of the Pathways interventions. School administration and lack of family participation were perceived barriers at some schools. Attitudes toward the program ranged from neutral to positive during the first year, with about two-thirds giving positive ratings, with greater variation in successive years. Overall, the mean score was 3.5 on a 5-point scale (1=very negative, 5=very positive). School climate score was positively associated with classroom curriculum and student exposure indices, but not with family attendance, food service, or physical activity implementation indices. The latter two indices were associated with site. CONCLUSIONS: An assessment of school climate through interviews is useful in understanding successes and failures in a school-based health intervention and can predict implementation success for some programs.

Child↗

PubMed2006

Perceived barriers to implementation of a successful sharps safety program.

IN RESPONSE TO INCREASING needle sticks and sharps injuries at a large, urban trauma center in the northeastern United States, a nurse educator assembled a focus group of OR staff members to determine what they perceived to be barriers to successful implementation of a sharps safety program. THE FOCUS GROUP IDENTIFIED inadequate communication, powerlessness, resistance to change, intimidation, inconsistencies in practice, negative attitudes, inexperienced staff members, and time constraints as barriers to a successful change implementation. USING THIS INFORMATION, the nurse educator identified strategies to implement a practice change to decrease the rate of needle sticks and sharps injuries.

Focus Groups↗

PubMed1996

Fellow of the American Dietetic Association credentialing program: development and implementation of a portfolio-based assessment.

This report has described the measurement and operational procedures used for the design, development, and implementation of the newly inaugurated Fellow of The American Dietetic Association credentialing program. The program was established to identify and certify registered dietitians who possess the characteristics of advanced-level practice. The main features of the Fellow program are as follows. It is based on the results of an empirical study that identified the characteristics of advanced-level practice. It is guided by the Fellow Assessment Plan, which specifies the content and level of dietetics practice involved and the psychometric and operational requirements for sound measurement. It is a performance-based portfolio assessment of six professional characteristics (education, work experience, professional achievement, professional roles, professional contacts, and approach to practice). It uses objective automated computer scoring and independent peer-review grading of candidate materials in relation to an explicit scoring rubric. It requires statistical analysis of the database of candidate scores, which is conducted to ensure that the scoring of candidate materials is accurate and reliable and that the assessment, as a measurement instrument, is psychometrically sound. It involves a standard-setting workshop in which a panel of subject-matter experts establish the lowest level of acceptable candidate performance on Approach to Practice; the passing standard for the other five characteristics was preestablished by the empirical study. A careful review of all evidence on the development and implementation of the 1994 Fellow assessment suggests that these procedures are technically sound and produce psychometrically defensible results. Our evaluation and commentary from CDR and CTB staff, subject-matter expert participants, and the candidates themselves suggested a number of ways to improve the Fellow program in subsequent administrations of the assessment. Changes have been implemented and CDR will continue to consider all data in its ongoing improvement efforts.

Credentialing↗